Paramedics wait outside of the UW Medical Center in mid-April.

As the COVID-19 pandemic continues to affect people across the country, there has been a concern that transplant surgery patients could be at a heightened risk for the disease. However, with collaborative policies and the availability of rapid testing, UW Medicine has been able to keep doing these life-saving procedures safely.

Ajit Limaye, director of UW Medicines Solid Organ Transplant Infectious Disease Program, said they have continued transplants with the exception of living donor kidney transplants in the last eight weeks amid increasing COVID-19 activity.

This decision to continue these procedures resulted from a combination of doing risk assessment and working with transplant leadership and the local organ procurement organization, LifeCenter Northwest (LCNW).

UW Medicine has also followed guidance issued by the Centers for Medicare & Medicaid Services which classified transplants as Tier 3b procedures that should not be delayed if possible.

Other recommendations from organizations such as the United Network for Organ Sharing have been directed to test donors for COVID-19.

While some centers may have chosen to pause transplants due to the potential risks of COVID-19 exposure, Limaye said UW Medicines immediate access to laboratory testing for both donors and recipients has allowed them to do transplants while maintaining the safety of patients and preventing transmission within the hospital.

A lot of transplant centers in the United States didnt have access to real-time testing, Limaye said. Most places are now getting up to speed, but we were well ahead of the curve in terms of implementing that.

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Although the number of transplants has decreased slightly since the COVID-19 outbreak, Limaye said its not what might be expected.

It's supply and demand so we have this demand of patients who are already on the list, but even the supply side was affected, Limaye said. Theres a lot of reasons that the number of donors has gone down a little bit over this period, but not as much as some people might have predicted.

Doctors have also been analyzing how transplant patients could be affected by COVID-19. There is not much known about this yet, but Nicolae Leca, medical director of UW Medicines Kidney and Pancreas Transplant Program, said the biggest concern is in the context of immunosuppression, which is part of the post-transplant period and can put patients at a higher risk of acquiring an infection.

However, Limaye said this doesnt necessarily mean transplant recipients will do worse if they get COVID-19. In a case series recently published by the American Journal of Transplantation, Limaye and his colleagues described four of the earliest COVID-19 cases in transplant patients from UW Medicines transplant program, all of whom are recovering and showed good outcomes despite being on immunosuppression.

As they continue to serve transplant patients and other patients across UW Medicines large area of clinical service, Leca said that they are providing telemedicine services for more effective communication, which is something they've been trying to implement for a long time.

Although the new normal will look appropriately different, I truly hope we can look forward to providing the same excellent transplant services beyond COVID-19, Leca said. Possibly even better, due to the changes we are making to our evaluation processes and improvement in patient satisfaction with telemedicine.

Currently, UW Medicine is working to reopen its living kidney donor program, which had previously been deferred, and Limaye said there are hopeful signs that the curve is flattening.

We have policies and procedures in place to keep it safe, both in the hospital as well as the community setting, Limaye said. We want to make sure that patients and the community understand all were doing to keep this life-saving procedure safe for people, and thats why weve continued.

Reach reporter Shannon Hong at news@dailyuw.com. Twitter: @shannonjhhong

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'We were well ahead of the curve': How UW Medicine has been continuing transplant surgeries in the face of COVID-19 - Dailyuw